tbuckley/cabot-search huggingface dataset:
Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults
Authors: Matthew E. Prekker, Brian E. Driver, Stacy A. Trent, Daniel Resnick-Ault, Kevin P. Seitz, Derek W. Russell, John P. Gaillard, Andrew J. Latimer, Shekhar A. Ghamande, Kevin W. Gibbs, Derek J. Vonderhaar, Micah R. Whitson, Christopher R. Barnes, Jeremy P. Walco, Ivor S. Douglas, Vijay Krishnamoorthy, Alon Dagan, Jill J. Bastman, Bradley D. Lloyd, Sheetal Gandotra, Jordan K. Goranson, Steven H. Mitchell, Heath D. White, Jessica A. Palakshappa, Alyssa Espinera, David B. Page, Aaron Joffe, Sydney J. Hansen, Christopher G. Hughes, Tobias George, J. Taylor Herbert, Nathan I. Shapiro, Steven G. Schauer, Brit J. Long, Brant Imhoff, Li Wang, Jillian P. Rhoads, Kelsey N. Womack, David R. Janz, Wesley H. Self, Todd W. Rice, Adit A. Ginde, Jonathan D. Casey, Matthew W. Semler
Journal: New England Journal of Medicine (2023)

Whether video laryngoscopy as compared with direct laryngoscopy increases the likelihood of successful tracheal intubation on the first attempt among critically ill adults is uncertain. Download a PDF of the Research Summary. In a multicenter, randomized trial conducted at 17 emergency departments and intensive care units (ICUs), we randomly assigned critically ill adults undergoing tracheal intubation to the video-laryngoscope group or the direct-laryngoscope group. The primary outcome was successful intubation on the first attempt. The secondary outcome was the occurrence of severe complications during intubation; severe complications were defined as severe hypoxemia, severe hypotension, new or increased vasopressor use, cardiac arrest, or death. The trial was stopped for efficacy at the time of the single preplanned interim analysis. Among 1417 patients who were included in the final analysis (91.5% of whom underwent intubation that was performed by an emergency medicine resident or a critical care fellow), successful intubation on the first attempt occurred in 600 of the 705 patients (85.1%) in the video-laryngoscope group and in 504 of the 712 patients (70.8%) in the direct-laryngoscope group (absolute risk difference, 14.3 percentage points; 95% confidence interval [CI], 9.9 to 18.7; P<0.001). A total of 151 patients (21.4%) in the video-laryngoscope group and 149 patients (20.9%) in the direct-laryngoscope group had a severe complication during intubation (absolute risk difference, 0.5 percentage points; 95% CI, −3.9 to 4.9). Safety outcomes, including esophageal intubation, injury to the teeth, and aspiration, were similar in the two groups. Among critically ill adults undergoing tracheal intubation in an emergency department or ICU, the use of a video laryngoscope resulted in a higher incidence of successful intubation on the first attempt than the use of a direct laryngoscope. (Funded by the U.S. Department of Defense; DEVICE ClinicalTrials.gov number, NCT05239195.) QUICK TAKE VIDEO SUMMARYVideo Laryngoscopy for Tracheal Intubation 02:12
Guidance on treatment endpoints and study design for clinical trials aiming to achieve cure in chronic hepatitis B and D: Report from the 2022 AASLD-EASL HBV-HDV Treatment Endpoints Conference
Authors: Marc G. Ghany, Maria Buti, Pietro Lampertico, Hannah M. Lee
Journal: Hepatology (2023)

Representatives from academia, industry, regulatory agencies, and patient advocacy groups convened under the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL) in June 2022 with the primary goal of achieving consensus on chronic HBV and HDV treatment endpoints to guide clinical trials aiming to “cure” HBV and HDV. Conference participants reached an agreement on some key points. The preferred primary endpoint for phase II/III trials evaluating finite treatments for chronic hepatitis B (CHB) is a “functional” cure, defined as sustained HBsAg loss and HBV DNA less than the lower limit of quantitation (LLOQ) 24 weeks off-treatment. An alternate endpoint would be “partial cure” defined as sustained HBsAg level &lt; 100 IU/mL and HBV DNA &lt; LLOQ 24 weeks off-treatment. Clinical trials should initially focus on patients with HBeAg positive or negative CHB, who are treatment-naive or virally suppressed on nucleos(t)ide analogs. Hepatitis flares may occur during curative therapy and should be promptly investigated and outcomes reported. HBsAg loss would be the preferred endpoint for chronic hepatitis D, but HDV RNA &lt; LLOQ 24 weeks off-treatment is a suitable alternate primary endpoint of phase II/III trials assessing finite strategies. For trials assessing maintenance therapy, the primary endpoint should be HDV RNA &lt; LLOQ assessed at on-treatment week 48. An alternate endpoint would be ≥2 log reduction in HDV RNA combined with normalization of alanine aminotransferase level. Suitable candidates for phase II/III trials would be treatment-naiive or experienced patients with quantifiable HDV RNA. Novel biomarkers (hepatitis B core–related antigen [HBcrAg] and HBV RNA) remain exploratory, while nucleos(t)ide analogs and pegylated interferon still have a role in combination with novel agents. Importantly, patient input is encouraged early on in drug development under the FDA/EMA patient–focused drug development programs.
Patient-reported outcomes with sarecycline treatment for acne vulgaris: Pooled analysis of phase 3 clinical studies
Authors: Julie C. Harper, April Armstrong, Richard G. Fried, Evan A. Rieder, Andrew F. Alexis, Raidah J. Salem, Ismail Kasujee, Ayman Grada
Journal: Journal of the American Academy of Dermatology (2023)

To the Editor: Acne vulgaris is a common chronic inflammatory skin disease that may cause long-term scarring with insufficient treatment.1 Furthermore, the highly visible nature of acne can affect social functioning and health-related quality of life (HRQOL).1 Systemic treatments including antibiotics, such as oral tetracycline-class antibiotics, are generally recommended for patients with moderate-to-severe acne.
Mammalian infections with highly pathogenic avian influenza viruses renew concerns of pandemic potential
Authors: Brad Gilbertson, Kanta Subbarao
Journal: The Journal of Experimental Medicine (2023)

There is unprecedented spread of highly pathogenic avian influenza A H5N1 viruses in bird species on five continents, and many reports of infections in mammals most likely resulting from consumption of infected birds. As H5N1 viruses infect more species, their geographical range increases and more viral variants are produced that could have new biological properties including adaptation to mammals and potentially to humans. This highlights the need to continually monitor and assess mammalian-origin H5N1 clade 2.3.4.4b viruses for the presence of mutations that could potentially increase their pandemic risk for humans. Fortunately, to date there have been a limited number of human cases, but infection of mammals increases the opportunity for the virus to acquire mutations that enhance efficient infection, replication, and spread in mammals, properties that have not been seen in these viruses in the past.
Panthenol Citrate Biomaterials Accelerate Wound Healing and Restore Tissue Integrity
Authors: Huifeng Wang, Chongwen Duan, Rebecca L. Keate, Guillermo A. Ameer
Journal: Advanced Healthcare Materials (2023)

Impaired wound healing is a common complication for diabetic patients and effective diabetic wound management remains a clinical challenge. Furthermore, a significant problem that contributes to patient morbidity is the suboptimal quality of healed skin, which often leads to reoccurring chronic skin wounds. Herein, a novel compound and biomaterial building block, panthenol citrate (PC), is developed. It has interesting fluorescence and absorbance properties, and it is shown that PC can be used in soluble form as a wash solution and as a hydrogel dressing to address impaired wound healing in diabetes. PC exhibits antioxidant, antibacterial, anti-inflammatory, and pro-angiogenic properties, and promotes keratinocyte and dermal fibroblast migration and proliferation. When applied in a splinted excisional wound diabetic rodent model, PC improves re-epithelialization, granulation tissue formation, and neovascularization. It also reduces inflammation and oxidative stress in the wound environment. Most importantly, it improves the regenerated tissue quality with enhanced mechanical strength and electrical properties. Therefore, PC could potentially improve wound care management for diabetic patients and play a beneficial role in other tissue regeneration applications.
Comparison of Female Ovarian Reserve Before vs After COVID-19 Vaccination
Authors: Liubin Yang, Samantha Neal, Tiffany Lee, Andrew Chou, Amy K. Schutt, William Gibbons
Journal: JAMA Network Open (2023)

This cohort study examines the association of COVID-19 vaccination with levels of anti-Mullerian hormone and antral follicle count in women seeking fertility treatment.
Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure
Authors: Peter J. Blankestijn, Robin W.M. Vernooij, Carinna Hockham, Giovanni F.M. Strippoli, Bernard Canaud, Jörgen Hegbrant, Claudia Barth, Adrian Covic, Krister Cromm, Andrea Cucui, Andrew Davenport, Matthias Rose, Marietta Török, Mark Woodward, Michiel L. Bots
Journal: New England Journal of Medicine (2023)

Several studies have suggested that patients with kidney failure may benefit from high-dose hemodiafiltration as compared with standard hemodialysis. However, given the limitations of the various published studies, additional data are needed.
Evolocumab has no effects on heart failure with reduced ejection fraction injury biomarkers: The <scp>EVO‐HF</scp> trial
Authors: Antoni Bayes‐Genis, Josep Lupón, Elena Revuelta‐Lopez, Cinta Llibre, Paloma Gastelurrutia, Mar Domingo, Germán Cediel, Pau Codina, Evelyn Santiago‐Vacas, Diego Rangel‐Sousa, Agustín Fernández‐Cisnal, Gema Miñana, Anna Mollar, Julio Núñez
Journal: European Journal of Heart Failure (2023)

Patients with heart failure with reduced ejection fraction (HFrEF) have not been shown to benefit from statins. We hypothesized that, by limiting disease progression in stable HFrEF of ischaemic etiology, the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab could reduce circulating troponin levels, a surrogate biomarker of myocyte injury and atherosclerosis progression.The EVO-HF multicentre prospective randomized trial compared evolocumab (420 mg/month administered subcutaneously) plus guideline-directed medical therapy (GDMT; n = 17) versus GDMT alone (n = 22) for 1 year in patients with stable coronary artery disease and left ventricular ejection fraction (LVEF) <40%, ischaemic aetiology, New York Heart Association class II, N-terminal pro-B-type natriuretic peptide (NT-proBNP) ≥400 pg/ml, high-sensitivity troponin T (hs-TnT) >10 pg/ml, low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dl. The primary endpoint was change in hs-TnT concentration. Secondary endpoints included NT-proBNP, interleukin-1 receptor-like 1 (ST2), high-sensitivity C-reactive protein (hs-CRP), LDL, low-density lipoprotein receptor (LDLR), high-density lipoprotein cholesterol (HDL-C), and PCSK9 levels at 1 year. Patients were mainly Caucasian (71.8%), male (79.5%), relatively young (mean age 68.1 ± 9.4 years), with a mean LVEF of 30.4 ± 6.5%, and managed with contemporary treatments. No significant changes in hs-TnT levels were observed in any group at 1 year. NT-proBNP and ST2 levels decreased in the GDMT plus evolocumab group (p = 0.045 and p = 0.008, respectively), without changes in hs-CRP, HDL-C, or LDLR. Total and LDL-C decreased in both groups, significantly higher in the intervention group (p = 0.003), and PCSK9 levels increased in the intervention group.This prospective randomized pilot trial, although with the limitation of the small sample size, does not support the benefit of evolocumab in reducing troponin levels in patients with elevated LDL-C levels, history of coronary artery disease, and stable HFrEF.
ASAS consensus definition of early axial spondyloarthritis
Authors: Victoria Navarro-Compán, Diego Benavent, Dafne Capelusnik, Désirée van der Heijde, Robert BM Landewé, Denis Poddubnyy, Astrid van Tubergen, Xenofon Baraliakos, Filip E Van den Bosch, Floris A van Gaalen, Lianne Gensler, Clementina López-Medina, Helena Marzo-Ortega, Anna Molto, Rodolfo Pérez-Alamino, Martin Rudwaleit, Marleen van de Sande, Raj Sengupta, Ulrich Weber, Sofia Ramiro
Journal: Annals of the Rheumatic Diseases (2023)

To develop a consensual definition for the term 'early axial spondyloarthritis-axSpA'-and 'early peripheral spondyloarthritis-pSpA'.
Emerging functions of tissue-resident eosinophils
Authors: Alessandra Gurtner, Daniel Crepaz, Isabelle C. Arnold
Journal: The Journal of Experimental Medicine (2023)

Eosinophils are typically considered tissue-damaging effector cells in type 2 immune-related diseases. However, they are also increasingly recognized as important modulators of various homeostatic processes, suggesting they retain the ability to adapt their function to different tissue contexts. In this review, we discuss recent progress in our understanding of eosinophil activities within tissues, with particular emphasis on the gastrointestinal tract, where a large population of these cells resides under non-inflammatory conditions. We further examine evidence of their transcriptional and functional heterogeneity and highlight environmental signals emerging as key regulators of their activities, beyond classical type 2 cytokines.
Vericiguat in heart failure with reduced ejection fraction: The right choice above all else? The answer may lie in time. Letter regarding the article ‘Effect of vericiguat on left ventricular structure and function in patients with heart failure with reduced ejection fraction: The <scp>VICTORIA</scp> echocardiographic substudy’
Authors: Sibo Wang, Qiushi Sun, Liansheng Wang
Journal: European Journal of Heart Failure (2023)
Trends in the Use of Gabapentinoids and Opioids in the Postoperative Period Among Older Adults
Authors: Tasce Bongiovanni, Siqi Gan, Emily Finlayson, Joseph S. Ross, James D. Harrison, W. John Boscardin, Michael A. Steinman
Journal: JAMA Network Open (2023)

Importance In response to the opioid epidemic, recommendations from some pain societies have encouraged surgeons to embrace multimodal pain regimens with the intent of reducing opioid use in the postoperative period, including by prescribing gabapentinoids. Objective To describe trends in postoperative prescribing of both gabapentinoids and opioids after a variety of surgical procedures by examining nationally representative Medicare data and further understand variation by procedure. Design, Setting, and Participants This serial cross-sectional study of gabapentinoid prescribing from January 1, 2013, through December 31, 2018, used a 20% US Medicare sample. Gabapentinoid-naive patients 66 years or older undergoing 1 of 14 common noncataract surgical procedures performed in older adults were included. Data were analyzed from April 2022 to April 2023. Exposure One of 14 common surgical procedures in older adults. Main Outcomes and Measures Rate of postoperative prescribing of gabapentinoids and opioids, defined as a prescription filled between 7 days before the procedure and 7 days after discharge from surgery. Additionally, concomitant prescribing of gabapentinoids and opioids in the postoperative period was assessed. Results The total study cohort included 494 922 patients with a mean (SD) age of 73.7 (5.9) years, 53.9% of whom were women and 86.0% of whom were White. A total of 18 095 patients (3.7%) received a new gabapentinoid prescription in the postoperative period. Of those receiving a new gabapentinoid prescription, 10 956 (60.5%) were women and 15 529 (85.8%) were White. After adjusting for age, sex, race and ethnicity, and procedure type in each year, the rate of new postoperative gabapentinoid prescribing increased from 2.3% (95% CI, 2.2%-2.4%) in 2014 to 5.2% (95% CI, 5.0%-5.4%) in 2018 ( P &amp;amp;lt; .001). While there was variation between procedure types, almost all procedures saw an increase in both gabapentinoid and opioid prescribing. In this same period, opioid prescribing increased from 56% (95% CI, 55%-56%) to 59% (95% CI, 58%-60%) ( P &amp;amp;lt; .001). Concomitant prescribing also increased from 1.6% (95% CI, 1.5%-1.7%) in 2014 to 4.1% (95% CI, 4.0%-4.3%) in 2018 ( P &amp;amp;lt; .001). Conclusions and Relevance The findings of this cross-sectional study of Medicare beneficiaries suggest that new postoperative gabapentinoid prescribing increased without a subsequent downward trend in the proportion of patients receiving postoperative opioids and a near tripling of concurrent prescribing. Closer attention needs to be paid to postoperative prescribing for older adults, especially when using multiple types of medications, which can have adverse drug events.
The Association Between Meningioma and Breast Cancer
Authors: Aurélie Degeneffe, Viviane De Maertelaer, Olivier De Witte, Florence Lefranc
Journal: JAMA Network Open (2023)

Importance A potential relationship between meningioma and breast cancer was suggested 70 years ago. However, to date, no conclusive evidence is available on this topic. Objective To provide a comprehensive review of the literature on the association of meningioma with breast cancer, supported by a meta-analysis. Data Sources A systematic PubMed search was performed up to April 2023 to identify articles on the association of meningioma with breast cancer. The following key words were used strategically: meningioma , breast cancer , breast carcinoma , association , relation . Study Selection All studies reporting women diagnosed with meningioma and breast cancer were identified. The search strategy was not limited by study design or publication date but only included articles in English. Additional articles were identified via citation searching. Studies reporting a complete population of meningiomas or breast cancer patients throughout a specific study period and a proportion of patients with a second pathology could be used for the meta-analysis. Data Extraction and Synthesis Data extraction was performed by 2 authors in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. Meta-analyses regarding both populations were performed using a random-effects model. Risk of bias was assessed. Main Outcomes and Measures The main measures were whether there was an increased prevalence of breast cancer in female patients with meningioma and whether there was an increased prevalence of meningioma in female patients with breast cancer. Results A total of 51 retrospective studies (case reports, case series, and cancer registry reports) describing 2238 patients with both diseases were identified; 18 studies qualified for prevalence analyses and meta-analysis. The random-effects meta-analysis (13 studies) revealed a significantly greater prevalence of breast cancer in female patients with meningioma than in the overall population (odds ratio [OR], 9.87; 95% CI, 7.31-13.32). Meningioma incidence in patients with breast cancer (11 studies) was greater than that in the baseline population; however, the difference according to the random-effects model was not statistically significant (OR, 1.41; 95% CI, 0.99-2.02). Conclusions and Relevance This large systematic review and the meta-analysis on the association between meningioma and breast cancer found nearly 10-fold higher odds of breast cancer in female patients with meningioma compared with the general female population. These findings suggest that female patients with meningioma should be screened more intensively for breast cancer. Further research is required to identify the factors causing this association.
SALL1 enforces microglia-specific DNA binding and function of SMADs to establish microglia identity
Authors: Bethany R. Fixsen, Claudia Z. Han, Yi Zhou, Nathanael J. Spann, Payam Saisan, Zeyang Shen, Christopher Balak, Mashito Sakai, Isidoro Cobo, Inge R. Holtman, Anna S. Warden, Gabriela Ramirez, Jana G. Collier, Martina P. Pasillas, Miao Yu, Rong Hu, Bin Li, Sarah Belhocine, David Gosselin, Nicole G. Coufal, Bing Ren, Christopher K. Glass
Journal: Nature Immunology (2023)

Abstract Spalt-like transcription factor 1 (SALL1) is a critical regulator of organogenesis and microglia identity. Here we demonstrate that disruption of a conserved microglia-specific super-enhancer interacting with the Sall1 promoter results in complete and specific loss of Sall1 expression in microglia. By determining the genomic binding sites of SALL1 and leveraging Sall1 enhancer knockout mice, we provide evidence for functional interactions between SALL1 and SMAD4 required for microglia-specific gene expression. SMAD4 binds directly to the Sall1 super-enhancer and is required for Sall1 expression, consistent with an evolutionarily conserved requirement of the TGFβ and SMAD homologs Dpp and Mad for cell-specific expression of Spalt in the Drosophila wing. Unexpectedly, SALL1 in turn promotes binding and function of SMAD4 at microglia-specific enhancers while simultaneously suppressing binding of SMAD4 to enhancers of genes that become inappropriately activated in enhancer knockout microglia, thereby enforcing microglia-specific functions of the TGFβ–SMAD signaling axis.
Racial Disparities in Lung Cancer Screening Among Veterans, 2013 to 2021
Authors: Neelima Navuluri, Samantha Morrison, Cynthia L. Green, Sandra L. Woolson, Isaretta L. Riley, Christopher E. Cox, Leah L. Zullig, Scott Shofer
Journal: JAMA Network Open (2023)

Importance Racial disparities in lung cancer screening (LCS) are often ascribed to barriers such as cost, insurance status, access to care, and transportation. Because these barriers are minimized within the Veterans Affairs system, there is a question of whether similar racial disparities exist within a Veterans Affairs health care system in North Carolina. Objectives To examine whether racial disparities in completing LCS after referral exist at the Durham Veterans Affairs Health Care System (DVAHCS) and, if so, what factors are associated with screening completion. Design, Setting, and Participants This cross-sectional study assessed veterans referred to LCS between July 1, 2013, and August 31, 2021, at the DVAHCS. All included veterans self-identified as White or Black and met the US Preventive Services Task Force eligibility criteria as of January 1, 2021. Participants who died within 15 months of consultation or who were screened before consultation were excluded. Exposures Self-reported race. Main Outcomes and Measures Screening completion was defined as completing computed tomography for LCS. The associations among screening completion, race, and demographic and socioeconomic risk factors were assessed using logistic regression models. Results A total of 4562 veterans (mean [SD] age, 65.4 [5.7] years; 4296 [94.2%] male; 1766 [38.7%] Black and 2796 [61.3%] White) were referred for LCS. Of all veterans referred, 1692 (37.1%) ultimately completed screening; 2707 (59.3%) never connected with the LCS program after referral and an informational mailer or telephone call, indicating a critical point in the LCS process. Screening rates were substantially lower among Black compared with White veterans (538 [30.5%] vs 1154 [41.3%]), with Black veterans having 0.66 times lower odds (95% CI, 0.54-0.80) of screening completion after adjusting for demographic and socioeconomic factors. Conclusions and Relevance This cross-sectional study found that after referral for initial LCS via a centralized program, Black veterans had 34% lower odds of LCS screening completion compared with White veterans, a disparity that persisted even after accounting for numerous demographic and socioeconomic factors. A critical point in the screening process was when veterans must connect with the screening program after referral. These findings may be used to design, implement, and evaluate interventions to improve LCS rates among Black veterans.